摘要
目的:探讨微创椎间孔镜手术联合中药熏洗在腰椎间盘突出症(LDH)治疗中的效果。方法:将95例LDH患者随机分为联合组48例和手术组47例。手术组实施微创孔镜手术治疗,联合组给予微创孔镜手术联合中药熏洗治疗。分析两组临床治疗效果、炎性介质C反应蛋白(CRP)、单核细胞趋化蛋白-1(MCP-1)、白介素1β(IL-1β)、疼痛程度VAS评分、腰椎功能障碍程度JOA评分、生活质量ODI评分及不良事件。结果:联合组治疗总有效率93.75%、不良事件发生率8.33%,分别与手术组91.49%和10.64%比较,差异无统计学意义(P>0.05);术后3 d、7 d联合组血清CRP、MCP-1、IL-1β水平低于手术组,差异有统计学意义(P<0.05);术后4周、12周联合组VAS、ODI评分低于手术组,JOA评分高于手术组(P<0.05)。结论:微创椎间孔镜手术联合中药熏洗治疗LDH能有效减轻炎症反应,缓解临床症状,提高患者生活质量。
Objective:To investigate the application effect of minimally invasive transforaminal endoscopic surgery combined with traditional Chinese medicine(TCM)fumigation in the treatment of patients with lumbar disc herniation(LDH).Methods:95 patients with LDH were randomly divided into two group,48 cases in the combined therapy group and 47 cases in the operation group.The operation group was treated with minimally invasive endoscopic surgery,while the combined therapy group were treated with minimally invasive endoscopic surgery combined with TCM fumigation and washing.The clinical effects,inflammatory mediators C-reactive protein(CRP),monocyte chemoattractant protein-1(MCP-1),interleukin-1β(IL-1β),pain scale VAS score,JOA score of lumbar dysfunctions,the Oswestry Disabiluty Index score,and adverse events were compared between the two groups.Results:Compared with the respective 91.49%and 10.64%in the operation group,the total effective rate and adverse events in the combined therapy group was the respective 93.75%and 8.33%,there were no statistical differences between the two groups(P>0.05);serum CRP,MCP-1 and IL-1βlevels of the combined therapy group were lower than those of the operation group after three and seven days of operation(P<0.05);VAS and ODI scores of the combined therapy group were lower than those of the operation group after four and twelve weeks of operation,but JOA score was higher than that of the operation group(P<0.05).Conclusion:Minimally invasive transforaminal endoscopic surgery combined with TCM fumigation and washing is effective in the treatment of LDH,which can effectively reduce inflammatory reaction,relieve clinical symptoms,and help to improve the quality of life in patients.
作者
翟迎敏
张玉民
王晓雨
ZHAI Yingmin;ZHANG Yumin;WANG Xiaoyu(The Third Department of Orthopedics,Puyang Hospital of Traditional Chinese Medicine,Puyang 457100,China)
出处
《华夏医学》
CAS
2023年第1期131-135,共5页
Acta Medicinae Sinica
关键词
椎间盘突出症
微创
中药熏洗
炎性介质
lumbar intervertebral disc herniation
minimally invasive
fumigation and washing with traditional Chinese medicine
inflammatory mediator
